NPI | 1750316162 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: CA LEP 1252) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFT 19168) |
Enumeration Date | 2006-07-12 |
Last Update Date | 2023-09-06 |